Sacroiliac joint fusion is a treatment approach to lower back and pelvis pain. The sacrum and the ilium naturally form a joint — and this fusion procedure joins the two together. If conservative treatment methods such as medications, exercises, and injections don’t help the back pain, surgical treatments in the form of a sacroiliac joint fusion may help.
Innovations in sacroiliac joint fusion have meant doctors can perform the surgery using a minimally invasive approach. Keep reading to learn about how and for who a sacroiliac joint fusion can help.
Researchers estimate 15 to 30 percent of all lower back pain experiences are due to sacroiliac joint dysfunction. This is likely because the sacroiliac joint is responsible for helping you bend and also withstands pressure while doing so, transferring force and pressure from your lower back to your legs.
Unfortunately, the sacroiliac joint is vulnerable to stress and injury that can lead to pain. The goal of this surgery is to reinforce this joint and reduce this pain.
In addition to pain relief,
- better quality of life
- enhanced daily function
- reduced disability
Adverse side effects aren’t usual following a sacroiliac joint fusion, but the most common risks of sacroiliac joint fusion are:
- new-onset back pain in another location
- trochanteric bursitis (hip pain)
- postprocedure wound infection
- bone fracture
- “nonunion” or failure of the bone to heal
Other potential, but less common, side effects include:
- hematoma (bruising/collection of blood)
- nerve pain
- blood clots in your legs or lungs
The ability to perform the surgery in a minimally invasive fashion has helped to
Surgeons can perform sacroiliac joint fusion using an open or minimally invasive approach.
Although there are
- A person goes to sleep under general anesthesia, where they’re asleep and unaware the surgery is taking place.
- The surgeon makes an incision in the lower back to expose the sacroiliac joint.
- A surgeon removes a block of bone to access the sacrum’s cartilage-covered surface.
- The surgeon removes the cartilage that’s over the sacrum.
- A surgeon replaces the block of bone and uses plates and screws to fix the bone in place to stabilize the joint.
Minimally invasive approach
The steps for a minimally invasive sacroiliac joint fusion are similar and
- The patient
- goes to sleep under general anesthesia, where they’re asleep and unaware the procedure is taking place.
- A surgeon makes a small,
3- to 5-centimeterincision on the side of the buttock.
- The surgeon dissects (cuts) through gluteal muscles to access the ilium, or upper portion of the pelvis.
- A surgeon uses a special guide pin to access the ilium and drill so implants can be passed toward the sacrum.
- A surgeon guides the instruments for implantation through the passage created in the ilium. The surgeon secures the implants using screws and pins.
- The surgeon irrigates (uses saline to clean) the surgical site to ensure there are no extra bits of bone or tissue. They then close the wound using sutures.
Medicare will typically cover sacroiliac joint fusion surgery, and the Medicare code for this surgery is 27279. Insurance companies will also typically cover this surgery, but you may have to obtain precertification prior to undergoing the surgery. Patient costs for this surgery typically depend upon where a surgeon performs it.
If the surgery takes place at an ambulatory surgery center, the patient typically pays $2,769, according to Medicare. If the surgery is at a hospital outpatient department, the patient typically pays $1,661. However, your costs may vary based on your location, health needs, and surgeon fees.
When the procedure is performed in a minimally invasive fashion, surgeons will typically encourage you to get up and walk around as quickly as you’re able after surgery. You may need an ambulatory assist device, such as a cane or crutches, to avoid excessive pressure on the operative site.
Surgeons will typically recommend limiting weight-bearing activity (how much heavy stuff you hold and move) for up to 6 weeks after surgery. However, some doctors may recommend avoiding heavy lifting for up to 12 weeks after surgery to ensure the bone and surgical implants are appropriately healing.
Doctors may recommend activity limitations that include refraining from lifting more than 10 pounds or bending at the waist excessively. A surgeon may recommend follow-up imaging about 6 months after surgery before you can return to full physical activity.
Sacroiliac joint fusion seems to be more effective in some people and less effective in others. The surgery seems to be
- older adults who have had back pain symptoms for a significant amount of time
- patients who haven’t had spine surgery before
The surgery seems to be
- those who take opioids (pain medication) most of the time
- those who smoke
- those who’ve undergone previous spinal fusion
A doctor will carefully study your symptoms to determine the likelihood the surgery will relieve your discomfort.
While you may not experience complete pain relief after sacroiliac joint fusion surgery, people do typically experience significant pain relief that
Sacroiliac joint dysfunction can contribute to lower back pain in some individuals. Sacroiliac joint fusion performed with a minimally invasive approach has improved outcomes and reduced recovery times.
If you experience significant lower back pain that conservative measures haven’t helped, you may want to talk with a doctor about this potential treatment approach.